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1.
Proc Natl Acad Sci U S A ; 117(1): 285-291, 2020 01 07.
Article in English | MEDLINE | ID: mdl-31871161

ABSTRACT

The impact of ultrasmall nanoparticles (<10-nm diameter) on the immune system is poorly understood. Recently, ultrasmall silica nanoparticles (USSN), which have gained increasing attention for therapeutic applications, were shown to stimulate T lymphocytes directly and at relatively low-exposure doses. Delineating underlying mechanisms and associated cell signaling will hasten therapeutic translation and is reported herein. Using competitive binding assays and molecular modeling, we established that the T cell receptor (TCR):CD3 complex is required for USSN-induced T cell activation, and that direct receptor complex-particle interactions are permitted both sterically and electrostatically. Activation is not limited to αß TCR-bearing T cells since those with γδ TCR showed similar responses, implying that USSN mediate their effect by binding to extracellular domains of the flanking CD3 regions of the TCR complex. We confirmed that USSN initiated the signaling pathway immediately downstream of the TCR with rapid phosphorylation of both ζ-chain-associated protein 70 and linker for activation of T cells protein. However, T cell proliferation or IL-2 secretion were only triggered by USSN when costimulatory anti-CD28 or phorbate esters were present, demonstrating that the specific impact of USSN is in initiation of the primary, nuclear factor of activated T cells-pathway signaling from the TCR complex. Hence, we have established that USSN are partial agonists for the TCR complex because of induction of the primary T cell activation signal. Their ability to bind the TCR complex rapidly, and then to dissolve into benign orthosilicic acid, makes them an appealing option for therapies targeted at transient TCR:CD3 receptor binding.


Subject(s)
Lymphocyte Activation/drug effects , Nanoparticles/chemistry , Receptor-CD3 Complex, Antigen, T-Cell/drug effects , Receptor-CD3 Complex, Antigen, T-Cell/metabolism , Silicon Dioxide/chemistry , Silicon Dioxide/pharmacology , CD28 Antigens/metabolism , CD3 Complex/chemistry , CD3 Complex/drug effects , Cell Proliferation/drug effects , Humans , Interleukin-2/metabolism , Models, Molecular , Phosphorylation , Receptor-CD3 Complex, Antigen, T-Cell/chemistry , Receptor-CD3 Complex, Antigen, T-Cell/genetics , Signal Transduction/immunology , T-Lymphocytes/drug effects , T-Lymphocytes/immunology , T-Lymphocytes/metabolism
2.
Medicine (Baltimore) ; 98(41): e17525, 2019 Oct.
Article in English | MEDLINE | ID: mdl-31593126

ABSTRACT

To assess the intra-individual and inter-individuals biological variation and the effect of aging on lymphocyte T-cells subsets.We assessed lymphocyte phenotypes (CD3, CD4, and CD8 T-cells) in 89 HIV-1-infected and 88 uninfected white non-Hispanic men every 6 months, to examine the biological variation for those measurements, and the average change in lymphocyte phenotype over 34 years.The markers showed significant intra-individuality in HIV-infected and uninfected individuals with index of individuality of <1.4. No mean changes were seen over the 34 years, with the exception of percentage CD4T-cells in HIV-uninfected individuals.In the pre-HAART era, HIV-infected individuals experienced an increase in mean absolute CD3 T-cell numbers (11.21 cells/µL, P = 0.02) and absolute CD8 T-cell numbers (34.57 cell/µl, P < .001), and in the percentage of CD8 T-cells (1.45%, P < .001) per year and a significant decrease in mean absolute CD4 T-cell numbers (23.68 cells/µl, P < .001) and in the percentage of CD4 T-cells (1.49%, P < .001) per year.In the post-HAART era, no changes in mean levels were observed in absolute CD3 T-cell count (P = .15) or percentage (P = .99). Significant decreases were seen in mean count (8.56 cells/µl, P < .001) and percentage (0.59%, P < .001) of CD8 T-cells, and increases in mean absolute count (10.72 cells/µl, P < .001) and percentage (0.47%, P < .001) of CD4 T-cells.With the exception of CD4 (%), no average changes per year were seen in lymphocyte phenotype of HIV-uninfected men. The results of coefficients of variation of intra and inter-individuals of this study can be useful for HIV-1 infection monitoring and in addition the observation could be a useful guide for intra- and inter-individual coefficient variations, and establishing quality goal studies of different blood biomarkers in healthy and other diseases.


Subject(s)
Acquired Immunodeficiency Syndrome/immunology , Biological Variation, Population/immunology , HIV Infections/immunology , T-Lymphocyte Subsets/immunology , Acquired Immunodeficiency Syndrome/ethnology , Adult , Aged , Aged, 80 and over , Antiretroviral Therapy, Highly Active/statistics & numerical data , Biological Variation, Population/ethnology , Biomarkers/blood , CD3 Complex/drug effects , CD3 Complex/immunology , CD3 Complex/metabolism , CD4 Antigens/immunology , CD4 Antigens/metabolism , CD8-Positive T-Lymphocytes/drug effects , CD8-Positive T-Lymphocytes/immunology , CD8-Positive T-Lymphocytes/metabolism , Cellular Senescence/immunology , Cohort Studies , HIV Infections/drug therapy , HIV Infections/metabolism , Humans , Los Angeles/epidemiology , Lymphocyte Count , Male , Middle Aged , Phenotype , T-Lymphocyte Subsets/metabolism
3.
Acta Cir Bras ; 33(7): 556-564, 2018 Jul.
Article in English | MEDLINE | ID: mdl-30110057

ABSTRACT

PURPOSE: To investigate the effects of baicalin on inflammatory reaction, oxidative stress and protein kinase D1 (PKD1) and nuclear factor-kappa B (NF-κB) protein expressions in severe acute pancreatitis (SAP) rats. METHODS: Sixty rats were divided into sham operation, model, and low-, medium- and high-dose baicalin group. SAP model was established in later 4 groups. The later 3 groups were injected with 0.1, 0.2 and 0.4 ml/100 g 5% baicalin injection, respectively. At 12 h, the serum SAP related indexes and inflammatory factors, peripheral blood CD3 and γδT cell percentages, wet/dry ratio and pancreas ascites volume, oxidative stress indexes and PKD1 and NF-κB protein expressions in pancreatic tissue were determined. RESULTS: Compared with model group, in high-dose baicalin group the wet/dry ratio and ascites volume, serum amylase level, phospholipase A2 activity, TNF-α, IL-1 and IL-6 levels, and pancreatic malondialdehyde level and PKD1 and NF-κB protein expression were significantly decreased (P < 0.05), and peripheral blood CD3 and γδT cell percentages and pancreatic superoxide dismutase and glutathione peroxidase levels were significantly increased (P < 0.05). CONCLUSION: Baicalin can resist the inflammatory reaction and oxidative stress, and down-regulate protein kinase D1 and nuclear factor-kappa B protein expressions, thus exerting the protective effects on severe acute pancreatitis in rats.


Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/pharmacology , Flavonoids/pharmacology , NF-kappa B/metabolism , Oxidative Stress/drug effects , Pancreatitis/drug therapy , Protein Kinase C/metabolism , Amylases/blood , Amylases/drug effects , Animals , CD3 Complex/blood , CD3 Complex/drug effects , Down-Regulation/drug effects , Glutathione Peroxidase/drug effects , Glutathione Peroxidase/metabolism , Interleukin-1/blood , Interleukin-6/blood , Malondialdehyde/metabolism , NF-kappa B/drug effects , Pancreatitis/metabolism , Protein Kinase C/drug effects , Random Allocation , Rats, Sprague-Dawley , Reproducibility of Results , Superoxide Dismutase/drug effects , Superoxide Dismutase/metabolism , Treatment Outcome , Tumor Necrosis Factor-alpha/blood , Tumor Necrosis Factor-alpha/drug effects
4.
Acta cir. bras ; 33(7): 556-564, July 2018. tab, graf
Article in English | LILACS | ID: biblio-949368

ABSTRACT

Abstract Purpose: To investigate the effects of baicalin on inflammatory reaction, oxidative stress and protein kinase D1 (PKD1) and nuclear factor-kappa B (NF-κB) protein expressions in severe acute pancreatitis (SAP) rats. Methods: Sixty rats were divided into sham operation, model, and low-, medium- and high-dose baicalin group. SAP model was established in later 4 groups. The later 3 groups were injected with 0.1, 0.2 and 0.4 ml/100 g 5% baicalin injection, respectively. At 12 h, the serum SAP related indexes and inflammatory factors, peripheral blood CD3 and γδT cell percentages, wet/dry ratio and pancreas ascites volume, oxidative stress indexes and PKD1 and NF-κB protein expressions in pancreatic tissue were determined. Results: Compared with model group, in high-dose baicalin group the wet/dry ratio and ascites volume, serum amylase level, phospholipase A2 activity, TNF-α, IL-1 and IL-6 levels, and pancreatic malondialdehyde level and PKD1 and NF-κB protein expression were significantly decreased (P < 0.05), and peripheral blood CD3 and γδT cell percentages and pancreatic superoxide dismutase and glutathione peroxidase levels were significantly increased (P < 0.05). Conclusion: Baicalin can resist the inflammatory reaction and oxidative stress, and down-regulate protein kinase D1 and nuclear factor-kappa B protein expressions, thus exerting the protective effects on severe acute pancreatitis in rats.


Subject(s)
Animals , Pancreatitis/drug therapy , Flavonoids/pharmacology , Protein Kinase C/metabolism , Anti-Inflammatory Agents, Non-Steroidal/pharmacology , NF-kappa B/metabolism , Oxidative Stress/drug effects , Pancreatitis/metabolism , Superoxide Dismutase/drug effects , Protein Kinase C/drug effects , Random Allocation , Down-Regulation/drug effects , Reproducibility of Results , NF-kappa B/drug effects , Interleukin-6/blood , Interleukin-1/blood , Tumor Necrosis Factor-alpha/blood , Treatment Outcome , Rats, Sprague-Dawley , CD3 Complex/drug effects , CD3 Complex/blood , Glutathione Peroxidase/drug effects , Glutathione Peroxidase/metabolism , Amylases/drug effects , Amylases/blood , Malondialdehyde/metabolism
6.
J Clin Oncol ; 34(10): 1104-11, 2016 Apr 01.
Article in English | MEDLINE | ID: mdl-26884582

ABSTRACT

PURPOSE: Blinatumomab is a CD19/CD3 BiTE (bispecific T-cell engager) antibody construct for the treatment of Philadelphia chromosome-negative acute B-lymphoblastic leukemia. We evaluated blinatumomab in relapsed/refractory B-cell non-Hodgkin lymphoma (NHL). PATIENTS AND METHODS: This 3 + 3 design, phase I dose-escalation study determined adverse events and the maximum tolerated dose (MTD) of continuous intravenous infusion blinatumomab in patients with relapsed/refractory NHL. Blinatumomab was administered over 4 or 8 weeks at seven different dose levels (0.5 to 90 µg/m(2)/day). End points were incidence of adverse events, pharmacokinetics, pharmacodynamics, and overall response rate. RESULTS: Between 2004 and 2011, 76 heavily pretreated patients with relapsed/refractory NHL, who included 14 with diffuse large B-cell lymphoma, were enrolled; 42 received treatment in the formal dose-escalation phase. Neurologic events were dose limiting, and 60 µg/m(2)/day was established as the MTD. Thirty-four additional patients were recruited to evaluate antilymphoma activity and strategies for mitigating neurologic events at a prespecified MTD. Stepwise dosing (5 to 60 µg/m(2)/day) plus pentosan polysulfate SP54 (n = 3) resulted in no treatment discontinuations; single-step (n = 5) and double-step (n = 24) dosing entailed two and seven treatment discontinuations due to neurologic events, respectively. Grade 3 neurologic events occurred in 22% of patients (no grade 4/5). Among patients treated at 60 µg/m(2)/day (target dose; n = 35), the overall response rate was 69% across NHL subtypes and 55% for diffuse large B-cell lymphoma (n = 11); median response duration was 404 days (95% CI, 207 to 1,129 days). CONCLUSION: In this phase I study of relapsed/refractory NHL, continuous infusion with CD19-targeted immunotherapy blinatumomab at various doses and schedules was feasible, with an MTD of 60 µg/m(2)/day. Single-agent blinatumomab showed antilymphoma activity.


Subject(s)
Antibodies, Bispecific/therapeutic use , Antineoplastic Agents/therapeutic use , Immunotherapy/methods , Lymphocyte Activation/drug effects , Lymphoma, Non-Hodgkin/drug therapy , Lymphoma, Non-Hodgkin/immunology , Molecular Targeted Therapy/methods , T-Lymphocytes/drug effects , T-Lymphocytes/immunology , Adult , Antibodies, Bispecific/administration & dosage , Antibodies, Bispecific/adverse effects , Antigens, CD19/drug effects , Antigens, CD19/immunology , Antineoplastic Agents/administration & dosage , Antineoplastic Agents/adverse effects , CD3 Complex/drug effects , CD3 Complex/immunology , Drug Administration Schedule , Female , Germany , Humans , Infusions, Intravenous , Lymphocyte Activation/immunology , Lymphoma, B-Cell/drug therapy , Lymphoma, B-Cell/immunology , Lymphoma, Follicular/drug therapy , Lymphoma, Follicular/immunology , Lymphoma, Mantle-Cell/drug therapy , Lymphoma, Mantle-Cell/immunology , Male , Maximum Tolerated Dose , Middle Aged , Nervous System Diseases/chemically induced , Recurrence , Remission Induction , Treatment Outcome
7.
Inflamm Bowel Dis ; 21(9): 2026-38, 2015 Sep.
Article in English | MEDLINE | ID: mdl-26002542

ABSTRACT

BACKGROUND: Chorioamnionitis results from an infection of the fetal membranes and is associated with fetal adverse outcomes notably in the intestine. Using a translational ovine model, we showed that intra-amniotic exposure to inflammatory stimuli decreased the regulatory/effector T (Treg/Teff) cell balance in the gut, which was accompanied by intestinal inflammation and mucosal injury. We thus aimed to augment the Treg/Teff cell ratio in the fetal gut by prophylactic IL-2 treatment and evaluate whether it is sufficient to prevent chorioamnionitis-induced intestinal inflammation and mucosal injury. METHODS: Fetal sheep (122 d of gestation) were intra-amniotically exposed to lipopolysaccharide for 2 or 7 days with or without prophylactic IL-2 treatment (4 d). We evaluated the infiltration of inflammatory cells in the ileum and mesenteric lymph nodes. Cytokine gene expression was analyzed in fetal ileum and the inflammatory changes were correlated with gut wall integrity. RESULTS: IL-2 administration preferentially increased intestinal Treg cells and thus the Treg/Teff cell ratio. Prophylactic IL-2 treatment reduced the lipopolysaccharide-induced influx of neutrophils and CD3(+) T cells and decreased the messenger RNA levels of proinflammatory cytokines including IL-6 and IL-17 in the fetal ileum. Importantly, prophylactic IL-2 treatment prevented mucosal damage without inducing fetal adverse treatment outcomes. CONCLUSIONS: Our data show that prophylactic IL-2 treatment prevents fetal intestinal inflammation and mucosal injury in the context of experimental chorioamnionitis. Modulation of the Treg/Teff cell balance may contribute to the protective effects of IL-2.


Subject(s)
Analgesics, Non-Narcotic/administration & dosage , Chorioamnionitis/pathology , Enteritis/prevention & control , Interleukin-2/administration & dosage , Prenatal Injuries/prevention & control , Analgesics, Non-Narcotic/pharmacology , Animals , CD3 Complex/drug effects , Chorioamnionitis/blood , Cytokines/genetics , Cytokines/metabolism , Disease Models, Animal , Female , Ileum/immunology , Ileum/pathology , Interleukin-2/pharmacology , Intestinal Mucosa/injuries , Intestinal Mucosa/pathology , Lipopolysaccharides , Lymph Nodes/metabolism , Mesentery , Neutrophils/drug effects , Pregnancy , Prenatal Injuries/etiology , Protective Agents/administration & dosage , Protective Agents/pharmacology , RNA, Messenger/drug effects , Random Allocation , Sheep , T-Lymphocytes, Regulatory/metabolism
8.
Int J Oncol ; 45(6): 2446-54, 2014 Dec.
Article in English | MEDLINE | ID: mdl-25242665

ABSTRACT

Targeting HER2 overexpressed breast cancer cells with anti­HER2 monoclonal antibodies inhibits tumor growth. Here we investigated whether HER2 can serve as a target for T cell-mediated immunotherapy of human colorectal carcinoma. Specific cytolytic activity of activated T cells (ATCs) armed with anti­CD3 x anti­HER2 bispecific antibody (HER2Bi-Ab) against HER2+ tumor cells was evaluated by bioluminescent signal generated by luciferase reporter on tumor cells in vitro and in vivo. In contrast to unarmed ATCs, increased cytotoxic activity of HER2Bi-armed ATCs against HER2+ tumor cells was observed. Moreover, HER2Bi-armed ATCs expressed higher level of activation marker CD69 and secreted significantly higher levels of IFN-γ than the unarmed ATC counterpart. In addition, compared with anti­HER2 mAb (Herceptin®) or unarmed ATC, HER2Bi-armed ATCs showed significant suppression against colorectal carcinoma cells. In colorectal tumor cell xenograft mice, infusion of HER2Bi-armed ATCs successfully inhibited the growth of Colo205-luc cells. The HER2Bi-armed ATCs with anti-tumor effects may provide a promising immunotherapy for colorectal carcinoma in the future.


Subject(s)
Antibodies, Bispecific/administration & dosage , Colorectal Neoplasms/drug therapy , Immunotherapy , Receptor, ErbB-2/biosynthesis , Animals , Antibodies, Bispecific/immunology , CD3 Complex/drug effects , CD3 Complex/immunology , Cell Line, Tumor , Colorectal Neoplasms/immunology , Colorectal Neoplasms/pathology , Gene Expression Regulation, Neoplastic/drug effects , Gene Expression Regulation, Neoplastic/immunology , Humans , Lymphocyte Activation/drug effects , Lymphocyte Activation/immunology , Mice , Receptor, ErbB-2/immunology , T-Lymphocytes, Cytotoxic/drug effects , T-Lymphocytes, Cytotoxic/immunology
9.
J Natl Cancer Inst ; 106(11)2014 Nov.
Article in English | MEDLINE | ID: mdl-25255802

ABSTRACT

BACKGROUND: Sipuleucel-T is a US Food and Drug Administration-approved immunotherapy for asymptomatic or minimally symptomatic metastatic castration-resistant prostate cancer (mCRPC). Its mechanism of action is not fully understood. This prospective trial evaluated the direct immune effects of systemically administered sipuleucel-T on prostatic cancer tissue in the preoperative setting. METHODS: Patients with untreated localized prostate cancer were treated on an open-label Phase II study of sipuleucel-T prior to planned radical prostatectomy (RP). Immune infiltrates in RP specimens (posttreatment) and in paired pretreatment biopsies were evaluated by immunohistochemistry (IHC). Correlations between circulating immune response and IHC were assessed using Spearman rank order. RESULTS: Of the 42 enrolled patients, 37 were evaluable. Adverse events were primarily transient, mild-to-moderate and infusion related. Patients developed T cell proliferation and interferon-γ responses detectable in the blood following treatment. Furthermore, a greater-than-three-fold increase in infiltrating CD3(+), CD4(+) FOXP3(-), and CD8(+) T cells was observed in the RP tissues compared with the pretreatment biopsy (binomial proportions: all P < .001). This level of T cell infiltration was observed at the tumor interface, and was not seen in a control group consisting of 12 concurrent patients who did not receive any neoadjuvant treatment prior to RP. The majority of infiltrating T cells were PD-1(+) and Ki-67(+), consistent with activated T cells. Importantly, the magnitude of the circulating immune response did not directly correlate with T cell infiltration within the prostate based upon Spearman's rank order correlation. CONCLUSIONS: This study is the first to demonstrate a local immune effect from the administration of sipuleucel-T. Neoadjuvant sipuleucel-T elicits both a systemic antigen-specific T cell response and the recruitment of activated effector T cells into the prostate tumor microenvironment.


Subject(s)
Cancer Vaccines/therapeutic use , Immunotherapy/methods , Interferon-gamma/drug effects , Lymphocyte Activation/drug effects , Neoadjuvant Therapy/methods , Prostatectomy , Prostatic Neoplasms, Castration-Resistant/drug therapy , Prostatic Neoplasms, Castration-Resistant/immunology , T-Lymphocytes/drug effects , Tissue Extracts/therapeutic use , Aged , CD3 Complex/drug effects , CD4-Positive T-Lymphocytes/drug effects , CD8-Positive T-Lymphocytes/drug effects , Cancer Vaccines/administration & dosage , Cancer Vaccines/adverse effects , Forkhead Transcription Factors/drug effects , Humans , Immunohistochemistry , Interferon-gamma/immunology , Lymphocyte Activation/immunology , Male , Middle Aged , Prospective Studies , Prostatectomy/methods , Prostatic Neoplasms, Castration-Resistant/pathology , Prostatic Neoplasms, Castration-Resistant/surgery , T-Lymphocytes/immunology , Tissue Extracts/administration & dosage , Tissue Extracts/adverse effects , Treatment Outcome , Tumor Microenvironment/drug effects , Tumor Microenvironment/immunology
10.
Immunotherapy ; 5(11): 1173-6, 2013 Nov.
Article in English | MEDLINE | ID: mdl-24188671

ABSTRACT

Goto R, You S, Zaitsu M, Chatenoud L, Wood KJ. Delayed anti-CD3 therapy results in depletion of alloreactive T cells and the dominance of Foxp3(+) CD4(+) graft infiltrating cells. Am. J. Transplant. 13(7), 1655-1664 (2013). Humanized Fc receptor nonbinding anti-CD3 monoclonal antibodies have been tested in patients with autoimmune diseases with the goal of inducing immune tolerance. However, the timing of drug administration may be an important determinant of the biologic effects, since not all T cells are equally affected, and there may be different subsets of cells involved during the evolution of immune responses. The study by Goto et al. showed that delayed administration of anti-CD3 therapy was more effective in depleting alloreactive T cells than administration at the time of transplant, and resulted in long-term survival of the graft by promoting infiltration of CD4 Tregs into the graft.


Subject(s)
Antibodies, Monoclonal, Humanized/therapeutic use , CD3 Complex/drug effects , CD4-Positive T-Lymphocytes/immunology , Forkhead Transcription Factors/immunology , Graft Rejection/prevention & control , Graft Survival/drug effects , Heart Transplantation/immunology , Repressor Proteins/immunology , Animals , Female , Male
11.
Diabetes Technol Ther ; 15 Suppl 2: S2-13-S2-20, 2013 Jun.
Article in English | MEDLINE | ID: mdl-23786294

ABSTRACT

Type 1 diabetes (T1D) results from the autoimmune destruction of pancreatic ß-cells, and as such it should respond to immunotherapy. George Eisenbarth gave many significant contributions to this field. He has been involved at some level in most immunotherapy trials during the past three decades. He was among the pioneers who attempted immunotherapy approaches in patients with recent-onset T1D. In the early 1980s he began studying relatives of those with the disease, leading to the concept that T1D was a chronic autoimmune disease, in which islet autoimmune responses would silently destroy ß-cells and cause progressive impairment of insulin secretion, years to months before a diagnosis was made. Consequently, he was one of the first to attempt immune intervention in people at high risk of T1D. Throughout his career he developed autoantibody assays and predictive models (which included metabolic testing and later genetics) to identify individuals at risk of T1D. He provided seminal intellectual contributions and critical tools for prevention trials. His focus on insulin as a critical autoantigen led to multiple prevention trials, including the Diabetes Prevention Trial-Type 1 (DPT-1), which studied both parenteral and oral insulin. In the DPT-1 Oral Insulin Trial, a cohort with higher levels of insulin autoantibodies was identified that appeared to have delayed disease progression. Type 1 Diabetes TrialNet is conducting a new trial to verify or refute this observation. Moreover, George identified and tested in the mouse small molecules that block or modulate presentation of a key insulin peptide and in turn prevent the activation of insulin-specific T-lymphocytes. Thus, we believe his greatest contribution is yet to come, as in the near future we should see this most recent work translate into clinical trials.


Subject(s)
Autoantibodies/adverse effects , Diabetes Mellitus, Type 1/immunology , Hypoglycemic Agents/therapeutic use , Immunotherapy , Insulin/therapeutic use , Abatacept , Animals , Antibodies, Monoclonal, Murine-Derived/therapeutic use , Autoantibodies/blood , Autoantigens/immunology , Autoantigens/therapeutic use , Autoimmune Diseases/drug therapy , Autoimmune Diseases/immunology , Autoimmunity/immunology , CD3 Complex/drug effects , Clinical Trials as Topic , Diabetes Mellitus, Type 1/drug therapy , Diabetes Mellitus, Type 1/prevention & control , Disease Models, Animal , Female , History, 20th Century , History, 21st Century , Humans , Immunoconjugates/therapeutic use , Immunotherapy/methods , Immunotherapy/trends , Insulin/metabolism , Insulin Antibodies/immunology , Insulin Secretion , Insulin-Secreting Cells/immunology , Male , Mice , Rituximab
12.
Am J Transplant ; 13(7): 1655-64, 2013 Jul.
Article in English | MEDLINE | ID: mdl-23750800

ABSTRACT

The engineered Fc-nonbinding (crystallizable fragment-nonbinding) CD3 antibody has lower mitogenicity and a precise therapeutic window for disease remission in patients with type 1 diabetes. Before anti-CD3 can be considered for use in transplantation, the most effective timing of treatment relative to transplantation needs to be elucidated. In this study anti-CD3F(ab')2 fragments or saline were administered intravenously for 5 consecutive days (early: d1-3 or delayed: d3-7) to mice transplanted with a cardiac allograft (H2(b)-to-H2(k); d0). Survival of allografts was prolonged in mice treated with the early protocol (MST = 48 days), but most were rejected by d100. In contrast, in mice treated with the delayed protocol allografts continued to survive long term. The delayed protocol significantly inhibited donor alloreactivity at d30 as compared to the early protocol. A marked increase in Foxp3(+) T cells (50.3 ± 1.6%) infiltrating the allografts in mice treated with the delayed protocol was observed (p < 0.0001 vs. early (24.9 ± 2.1%)) at d10; a finding that was maintained in the accepted cardiac allografts at d100. We conclude that the timing of treatment with anti-CD3 therapy is critical for inducing long-term graft survival. Delaying administration effectively inhibits the alloreactivity and promotes the dominance of intragraft Foxp3(+) T cells allowing long-term graft acceptance.


Subject(s)
Antibodies, Monoclonal, Humanized/therapeutic use , CD3 Complex/drug effects , CD4-Positive T-Lymphocytes/immunology , Forkhead Transcription Factors/immunology , Graft Rejection/prevention & control , Graft Survival/drug effects , Heart Transplantation/immunology , Repressor Proteins/immunology , Animals , CD3 Complex/immunology , CD4-Positive T-Lymphocytes/drug effects , CD4-Positive T-Lymphocytes/pathology , Cells, Cultured , Disease Models, Animal , Enzyme-Linked Immunospot Assay , Female , Flow Cytometry , Follow-Up Studies , Forkhead Transcription Factors/drug effects , Graft Rejection/immunology , Graft Rejection/pathology , Graft Survival/immunology , Heart Transplantation/pathology , Immunohistochemistry , Immunosuppression Therapy/methods , Male , Mice , Mice, Inbred C57BL , Mice, Inbred CBA , Mice, Transgenic , Repressor Proteins/drug effects , Time Factors , Transplantation, Homologous
13.
Lancet ; 378(9790): 487-97, 2011 Aug 06.
Article in English | MEDLINE | ID: mdl-21719095

ABSTRACT

BACKGROUND: Findings of small studies have suggested that short treatments with anti-CD3 monoclonal antibodies that are mutated to reduce Fc receptor binding preserve ß-cell function and decrease insulin needs in patients with recent-onset type 1 diabetes. In this phase 3 trial, we assessed the safety and efficacy of one such antibody, teplizumab. METHODS: In this 2-year trial, patients aged 8-35 years who had been diagnosed with type 1 diabetes for 12 weeks or fewer were enrolled and treated at 83 clinical centres in North America, Europe, Israel, and India. Participants were allocated (2:1:1:1 ratio) by an interactive telephone system, according to computer-generated block randomisation, to receive one of three regimens of teplizumab infusions (14-day full dose, 14-day low dose, or 6-day full dose) or placebo at baseline and at 26 weeks. The Protégé study is still underway, and patients and study staff remain masked through to study closure. The primary composite outcome was the percentage of patients with insulin use of less than 0·5 U/kg per day and glycated haemoglobin A(1c) (HbA(1C)) of less than 6·5% at 1 year. Analyses included all patients who received at least one dose of study drug. This trial is registered with ClinicalTrials.gov, number NCT00385697. FINDINGS: 763 patients were screened, of whom 516 were randomised to receive 14-day full-dose teplizumab (n=209), 14-day low-dose teplizumab (n=102), 6-day full-dose teplizumab (n=106), or placebo (n=99). Two patients in the 14-day full-dose group and one patient in the placebo group did not start treatment, so 513 patients were eligible for efficacy analyses. The primary outcome did not differ between groups at 1 year: 19·8% (41/207) in the 14-day full-dose group; 13·7% (14/102) in the 14-day low-dose group; 20·8% (22/106) in the 6-day full-dose group; and 20·4% (20/98) in the placebo group. 5% (19/415) of patients in the teplizumab groups were not taking insulin at 1 year, compared with no patients in the placebo group at 1 year (p=0·03). Across the four study groups, similar proportions of patients had adverse events (414/417 [99%] in the teplizumab groups vs 98/99 [99%] in the placebo group) and serious adverse events (42/417 [10%] vs 9/99 [9%]). The most common clinical adverse event in the teplizumab groups was rash (220/417 [53%] vs 20/99 [20%] in the placebo group). INTERPRETATION: Findings of exploratory analyses suggest that future studies of immunotherapeutic intervention with teplizumab might have increased success in prevention of a decline in ß-cell function (measured by C-peptide) and provision of glycaemic control at reduced doses of insulin if they target patients early after diagnosis of diabetes and children. FUNDING: MacroGenics, the Juvenile Diabetes Research Foundation, and Eli Lilly.


Subject(s)
CD3 Complex/drug effects , Diabetes Mellitus, Type 1/drug therapy , Diabetes Mellitus, Type 1/immunology , Hypoglycemic Agents/therapeutic use , Insulin/therapeutic use , Muromonab-CD3/therapeutic use , Adolescent , Adult , Antibodies, Monoclonal, Humanized , C-Peptide/blood , CD3 Complex/immunology , Canada , Child , Diabetes Mellitus, Type 1/blood , Drug Administration Schedule , Drug Eruptions/etiology , Europe , Female , Glycated Hemoglobin/metabolism , Humans , Hypoglycemic Agents/administration & dosage , Hypoglycemic Agents/adverse effects , Hypoglycemic Agents/immunology , India , Insulin/administration & dosage , Insulin-Secreting Cells/drug effects , Insulin-Secreting Cells/immunology , Israel , Male , Mexico , Muromonab-CD3/administration & dosage , Muromonab-CD3/adverse effects , Muromonab-CD3/immunology , Treatment Outcome , United States , Young Adult
16.
Immunology ; 130(1): 103-13, 2010 May.
Article in English | MEDLINE | ID: mdl-20059577

ABSTRACT

It has been established that a total of 250 microg of monoclonal anti-mouse CD3 F(ab')(2) fragments, administered daily (50 microg per dose), induces remission of diabetes in the non-obese diabetic (NOD) mouse model of autoimmune diabetes by preventing beta cells from undergoing further autoimmune attack. We evaluated lower-dose regimens of monoclonal anti-CD3 F(ab')(2) in diabetic NOD mice for their efficacy and associated pharmacodynamic (PD) effects, including CD3-T-cell receptor (TCR) complex modulation, complete blood counts and proportions of circulating CD4(+), CD8(+) and CD4(+) FoxP3(+) T cells. Four doses of 2 microg (total dose 8 microg) induced 53% remission of diabetes, similarly to the 250 microg dose regimen, whereas four doses of 1 microg induced only 16% remission. While the 250 microg dose regimen produced nearly complete and sustained modulation of the CD3 -TCR complex, lower doses, spaced 3 days apart, which induced similar remission rates, elicited patterns of transient and partial modulation. In treated mice, the proportions of circulating CD4(+) and CD8(+) T cells decreased, whereas the proportions of CD4(+) FoxP3(+) T cells increased; these effects were transient. Mice with greater residual beta-cell function, estimated using blood glucose and C-peptide levels at the initiation of treatment, were more likely to enter remission than mice with more advanced disease. Thus, lower doses of monoclonal anti-CD3 that produced only partial and transient modulation of the CD3-TCR complex induced remission rates comparable to higher doses of monoclonal anti-CD3. Accordingly, in a clinical setting, lower-dose regimens may be efficacious and may also improve the safety profile of therapy with monoclonal anti-CD3, potentially including reductions in cytokine release-related syndromes and maintenance of pathogen-specific immunosurveillance during treatment.


Subject(s)
Antibodies, Monoclonal/administration & dosage , CD3 Complex/drug effects , Diabetes Mellitus, Type 1/drug therapy , Animals , Antibodies, Monoclonal/pharmacokinetics , CD4-Positive T-Lymphocytes/drug effects , CD4-Positive T-Lymphocytes/immunology , CD8-Positive T-Lymphocytes/drug effects , CD8-Positive T-Lymphocytes/immunology , Cell Separation , Diabetes Mellitus, Type 1/immunology , Dose-Response Relationship, Drug , Female , Flow Cytometry , Mice , Mice, Inbred BALB C , Mice, Inbred NOD , Pancreas/drug effects , Pancreas/pathology , Remission Induction , T-Lymphocyte Subsets/drug effects , T-Lymphocyte Subsets/immunology
17.
J Immunol ; 183(8): 4843-7, 2009 Oct 15.
Article in English | MEDLINE | ID: mdl-19801510

ABSTRACT

MHC class II expression identifies an effector subset of human CD4(+)CD25(high)FoxP3(high) natural regulatory T cells (DR(+) Tregs) that induces more rapid suppression and exhibits higher FoxP3 expression than the remaining Treg population. Although Tregs are known to be highly sensitive to apoptosis, in this study we demonstrate that this sensitivity is primarily a feature of DR(+) Tregs. Granzyme B (GzmB) is strongly expressed by nonregulatory responder CD4 T cells, whereas effector DR(+) Tregs express little GzmB. Strong TCR stimulation markedly increases the expression of GzmB in all dividing responder CD4 T cells and mitigates the suppression by DR(+) Tregs. DR(+) Treg suppressive activity reemerges if GzmB is neutralized. We show that responder cells actively kill effector Tregs by producing GzmB in response to strong TCR stimulation. Thus, the production of GzmB by strongly activated CD4 T cells represents a mechanism by which CD4 T cells resist Treg suppression.


Subject(s)
Granzymes/metabolism , Immune Tolerance , Receptors, Antigen, T-Cell/immunology , T-Lymphocyte Subsets/immunology , T-Lymphocytes, Regulatory/immunology , Antibodies, Monoclonal/immunology , Apoptosis/drug effects , Apoptosis/immunology , CD2 Antigens/drug effects , CD2 Antigens/immunology , CD2 Antigens/metabolism , CD3 Complex/drug effects , CD3 Complex/immunology , CD3 Complex/metabolism , Cells, Cultured , Granzymes/drug effects , Granzymes/immunology , Humans , Immunologic Factors/pharmacology , Lymphocyte Activation/drug effects , Lymphocyte Activation/immunology , RNA, Small Interfering/immunology , RNA, Small Interfering/metabolism , Receptors, Antigen, T-Cell/drug effects , Receptors, Antigen, T-Cell/metabolism , T-Lymphocyte Subsets/drug effects , T-Lymphocyte Subsets/enzymology , T-Lymphocytes, Regulatory/drug effects , T-Lymphocytes, Regulatory/enzymology
18.
J Immunol ; 183(8): 4895-903, 2009 Oct 15.
Article in English | MEDLINE | ID: mdl-19801514

ABSTRACT

The definitions of tolerogenic vs immunogenic dendritic cells (DC) remain controversial. Immature DC have been shown to induce T regulatory cells (Treg) specific for foreign and allogeneic Ags. However, we have previously reported that mature DC (mDC) prevented the onset of autoimmune diabetes, whereas immature DC (iDC) were therapeutically ineffective. In this study, islet-specific CD4(+) T cells from BDC2.5 TCR-transgenic mice were stimulated in the absence of exogenous cytokine with iDC or mDC pulsed with high- or low-affinity antigenic peptides and examined for Treg induction. Both iDC and mDC presenting low peptide doses induced weak TCR signaling via the Akt/mammalian target of rapamycin (mTOR) pathway, resulting in significant expansion of Foxp3(+) Treg. Furthermore, unpulsed mDC, but not iDC, also induced Treg. High peptide doses induced strong Akt/mTOR signaling and favored the expansion of Foxp3(neg) Th cells. The inverse correlation of Foxp3 and Akt/mTOR signaling was also observed in DO11.10 and OT-II TCR-transgenic T cells and was recapitulated with anti-CD3/CD28 stimulation in the absence of DC. IL-6 production in these cultures correlated positively with Ag dose and inversely with Treg expansion. Studies with T cells or DC from IL-6(-/-) mice revealed that IL-6 production by T cells was more important in the inhibition of Treg induction at low Ag doses. These studies indicate that the strength of Akt/mTOR signaling, a critical T cell-intrinsic determinant for Treg vs Th induction, can be controlled by adjusting the dose of antigenic peptide. Furthermore, this operates in a dominant fashion over DC phenotype and cytokine production.


Subject(s)
Antigens/immunology , CD4-Positive T-Lymphocytes/immunology , Dendritic Cells/immunology , Diabetes Mellitus, Type 1/immunology , Interleukin-6/metabolism , T-Lymphocytes, Regulatory/immunology , Animals , Antibodies/immunology , CD28 Antigens/drug effects , CD28 Antigens/immunology , CD28 Antigens/metabolism , CD3 Complex/drug effects , CD3 Complex/immunology , CD3 Complex/metabolism , CD4-Positive T-Lymphocytes/metabolism , Carrier Proteins/immunology , Carrier Proteins/metabolism , Coculture Techniques , Cytokines/biosynthesis , Cytokines/immunology , Dendritic Cells/metabolism , Dose-Response Relationship, Immunologic , Forkhead Transcription Factors/immunology , Interleukin-6/genetics , Interleukin-6/immunology , Mice , Mice, Inbred BALB C , Mice, Inbred C57BL , Mice, Inbred NOD , Mice, Knockout , Oncogene Protein v-akt/immunology , Oncogene Protein v-akt/metabolism , Ovalbumin/immunology , Peptides/immunology , Phosphotransferases (Alcohol Group Acceptor)/immunology , Phosphotransferases (Alcohol Group Acceptor)/metabolism , Receptors, Antigen, T-Cell/immunology , Receptors, Antigen, T-Cell/metabolism , Signal Transduction/immunology , T-Lymphocytes, Regulatory/metabolism , TOR Serine-Threonine Kinases
19.
J Immunol ; 183(8): 4853-7, 2009 Oct 15.
Article in English | MEDLINE | ID: mdl-19786544

ABSTRACT

We report that OX40 stimulation drives all lineages of CD4 T cell development, including regulatory T cells (Tregs), and the plasticity of the response is dependant on local cytokines. In TGF-beta1-treated cultures, an OX40 agonist increased IFN-gamma and IL-4 production and diverted T cells from the Treg lineage. However, cytokine blockade in the context of OX40 stimulation promoted enhanced Treg accumulation. This observation was evident in naive mice, as OX40 engagement enhanced Treg proliferation and accumulation in vivo. Lastly, OX40 agonist administration influenced experimental autoimmune encephalomyelitis disease severity in opposing directions, depending on the timing of administration. Given during Ag priming, the OX40 agonist drove Treg expansion and inhibited disease, whereas given later it enhanced T cell effector cytokine production in the CNS and exacerbated disease. Hence, OX40 signaling can augment the accumulation of all CD4 T cell lineages; however, its accentuation of immune responses may have vastly different biologic outcomes depending upon the local cytokine milieu.


Subject(s)
Cytokines/immunology , Encephalomyelitis, Autoimmune, Experimental/immunology , Receptors, OX40/agonists , T-Lymphocytes, Regulatory/drug effects , Adoptive Transfer , Animals , Antibodies/administration & dosage , Antibodies/immunology , CD28 Antigens/drug effects , CD28 Antigens/immunology , CD28 Antigens/metabolism , CD3 Complex/drug effects , CD3 Complex/immunology , CD3 Complex/metabolism , Cell Differentiation/drug effects , Cell Differentiation/immunology , Encephalomyelitis, Autoimmune, Experimental/metabolism , Female , Interferon-gamma/antagonists & inhibitors , Interferon-gamma/immunology , Interferon-gamma/metabolism , Interferon-gamma/pharmacology , Interleukin-4/antagonists & inhibitors , Interleukin-4/immunology , Interleukin-4/metabolism , Mice , Mice, Inbred C57BL , Mice, Knockout , Receptors, OX40/immunology , T-Lymphocytes, Regulatory/immunology , Transforming Growth Factor beta1/pharmacology
20.
Scand J Immunol ; 70(3): 206-15, 2009 Sep.
Article in English | MEDLINE | ID: mdl-19703010

ABSTRACT

CD25 monoclonal antibody binding to the alpha-chain of the Interleukin-2 (IL-2) receptor, blocks high-affinity IL-2 binding, thereby preventing complete T-cell activation and being of ample importance in transplantation medicine and potentially the treatment of autoimmune disease. However, CD25 antibodies do not only block T-cell activation but also prevent activation-induced cell death (AICD) attributing a dual function to IL-2. In this study, the modulation of the genomic expression profile of human peripheral blood mononuclear cells (PBMC) with therapeutic concentrations of humanized anti-CD25 mAb was investigated. PBMC were stimulated with CD3 antibody OKT-3 together with recombinant IL-2 in the absence or presence of anti-CD25 mAb. RNA was extracted and subjected to microarray analysis on U133A microarrays (Affymetrix). Anti-CD25 treatment inhibited several genes typically expressed during T-cell activation including granzyme B, signalling lymphocyte activation molecule, family member 1 (SLAMF1), CD40-Ligand (CD40-L), IL-9 and interferon (IFN)-gamma. Interestingly, anti-CD25 mAb also blocked the expression of several genes important for susceptibility to apoptosis, such as death receptor 6 (DR6) or reversed IL-2-mediated repression of anti-apoptotic genes, such as Fas apoptotic inhibitory molecule 3 (FAIM3)/TOSO. Functional significance of DR6 and TOSO expression in IL-2-dependent T-cell activation was subsequently evaluated by RNA interference in AICD: While siRNA specifically directed against DR6 did not modulate FAS-L-mediated apoptosis induction in primary T cells, down-regulation of TOSO significantly increased susceptibility to apoptosis, emphasizing an important role for TOSO in IL-2-mediated AICD.


Subject(s)
Apoptosis Regulatory Proteins/biosynthesis , Apoptosis/immunology , CD3 Complex/immunology , Interleukin-2 Receptor alpha Subunit/antagonists & inhibitors , Membrane Proteins/biosynthesis , T-Lymphocytes/immunology , Antibodies, Monoclonal/immunology , Antineoplastic Agents/pharmacology , Apoptosis Regulatory Proteins/genetics , CD3 Complex/drug effects , CD3 Complex/metabolism , Down-Regulation/drug effects , Down-Regulation/immunology , Gene Expression Profiling , Gene Silencing/immunology , Humans , Interleukin-2/pharmacology , Interleukin-2 Receptor alpha Subunit/immunology , Lymphocyte Activation/drug effects , Lymphocyte Activation/immunology , Membrane Proteins/genetics , Oligonucleotide Array Sequence Analysis , RNA, Small Interfering/immunology , RNA, Small Interfering/metabolism , Receptors, Tumor Necrosis Factor/genetics , Receptors, Tumor Necrosis Factor/immunology , Receptors, Tumor Necrosis Factor/metabolism , T-Lymphocytes/drug effects , T-Lymphocytes/metabolism
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